SECT. XXVIII.
OF THE PARALYSIS OF THE ABSORBENT SYSTEM.
I. _Paralysis of the lacteals, atrophy. Distaste to animal food._ II.
_Cause of dropsy. Cause of herpes. Scrophula. Mesenteric consumption.
Pulmonary consumption. Why ulcers in the lungs are so difficult to heal._
The term paralysis has generally been used to express the loss of voluntary motion, as in the hemiplagia, but may with equal propriety be applied to express the disobediency of the muscular fibres to the other kinds of stimulus; as to those of irritation or sensation.
I. There is a species of atrophy, which has not been well understood; when the absorbent vessels of the stomach and intestines have been long inured to the stimulus of too much spirituous liquor, they at length, either by the too sudden omission of fermented or spirituous potation, or from the gradual decay of nature, become in a certain degree paralytic; now it is observed in the larger muscles of the body, when one side is paralytic, the other is more frequently in motion, owing to the less expenditure of sensorial power in the paralytic limbs; so in this case the other part of the absorbent system acts with greater force, or with greater perseverance, in consequence of the paralysis of the lacteals; and the body becomes greatly emaciated in a small time.
I have seen several patients in this disease, of which the following are the circ.u.mstances. 1. They were men about fifty years of age, and had lived freely in respect to fermented liquors. 2. They lost their appet.i.te to animal food. 3. They became suddenly emaciated to a great degree. 4. Their skins were dry and rough. 5. They coughed and expectorated with difficulty a viscid phlegm. 6. The membrane of the tongue was dry and red, and liable to become ulcerous.
The inability to digest animal food, and the consequent distaste to it, generally precedes the dropsy, and other diseases, which originate from spirituous potation. I suppose when the stomach becomes inirritable, that there is at the same time a deficiency of gastric acid; hence milk seldom agrees with these patients, unless it be previously curdled, as they have not sufficient gastric acid to curdle it; and hence vegetable food, which is itself acescent, will agree with their stomachs longer than animal food, which requires more of the gastric acid for its digestion.
In this disease the skin is dry from the increased absorption of the cutaneous lymphatics, the fat is absorbed from the increased absorption of the cellular lymphatics, the mucus of the lungs is too viscid to be easily spit up by the increased absorption of the thinner parts of it, the membrana sneideriana becomes dry, covered with hardened mucus, and at length becomes inflamed and full of aphthae, and either these sloughs, or pulmonary ulcers, terminate the scene.
II. The immediate cause of dropsy is the paralysis of some other branches of the absorbent system, which are called lymphatics, and which open into the larger cavities of the body, or into the cells of the cellular membrane; whence those cavities or cells become distended with the fluid, which is hourly secreted into them for the purpose of lubricating their surfaces. As is more fully explained in No. 5. of the next Section.
As those lymphatic vessels consist generally of a long neck or mouth, which drinks up its appropriated fluid, and of a conglobate gland, in which this fluid undergoes some change, it happens, that sometimes the mouth of the lymphatic, and sometimes the belly or glandular part of it, becomes totally or partially paralytic. In the former case, where the mouths of the cutaneous lymphatics become torpid or quiescent, the fluid secreted on the skin ceases to be absorbed, and erodes the skin by its saline acrimony, and produces eruptions termed herpes, the discharge from which is as salt, as the tears, which are secreted too fast to be reabsorbed, as in grief, or when the puncta lacrymalia are obstructed, and which running down the cheek redden and inflame the skin.
When the mouths of the lymphatics, which open on the mucous membrane of the nostrils, become torpid, as on walking into the air in a frosty morning; the mucus, which continues to be secreted, has not its aqueous and saline part reabsorbed, which running over the upper lip inflames it, and has a salt taste, if it falls on the tongue.
When the belly, or glandular part of these lymphatics, becomes torpid, the fluid absorbed by its mouth stagnates, and forms a tumour in the gland.
This disease is called the scrophula. If these glands suppurate externally, they gradually heal, as those of the neck; if they suppurate without an opening on the external habit, as the mesenteric glands, a hectic fever ensues, which destroys the patient; if they suppurate in the lungs, a pulmonary consumption ensues, which is believed thus to differ from that described in the preceding Section, in respect to its seat or proximate cause.
It is remarkable, that matter produced by suppuration will lie concealed in the body many weeks, or even months, without producing hectic fever; but as soon as the wound is opened, so as to admit air to the surface of the ulcer, a hectic fever supervenes, even in very few hours, which is probably owing to the azotic part of the atmosphere rather than to the oxygene; because those medicines, which contain much oxygene, as the calces or oxydes of metals, externally applied, greatly contribute to heal ulcers, of these are the solutions of lead and mercury, and copper in acids, or their precipitates.
Hence when wounds are to be healed by the first intention, as it is called, it is necessary carefully to exclude the air from them. Hence we have one cause, which prevents pulmonary ulcers from healing, which is their being perpetually exposed to the air.
Both the dark-eyed patients, which are affected with pulmonary ulcers from deficient venous absorption, as described in Section. XXVII. 2. and the light-eyed patients from deficient lymphatic absorption, which we are now treating of, have generally large apertures of the iris; these large pupils of the eyes are a common mark of want of irritability; and it generally happens, that an increase of sensibility, that is, of motions in consequence of sensation, attends these const.i.tutions. See Sect. x.x.xI. 2.
Whence inflammations may occur in these from stagnated fluids more frequently than in those const.i.tutions, which possess more irritability and less sensibility.
Great expectations in respect to the cure of consumptions, as well as of many other diseases, are produced by the very ingenious exertions of DR.
BEDDOES; who has established an apparatus for breathing various mixtures of airs or ga.s.ses, at the hot-wells near Bristol, which well deserves the attention of the public.
DR. BEDDOES very ingeniously concludes, from the florid colour of the blood of consumptive patients, that it abounds in oxygene; and that the redness of their tongues, and lips, and the fine blush of their cheeks shew the presence of the same principle, like flesh reddened by nitre. And adds, that the circ.u.mstance of the consumptions of pregnant women being stopped in their progress during pregnancy, at which time their blood may be supposed to be in part deprived of its oxygene, by oxygenating the blood of the foetus, is a forceable argument in favour of this theory; which must soon be confirmed or confuted by his experiments. See Essay on Scurvy, Consumption, &c. by Dr. Beddoes. Murray. London. Also Letter to Dr. Darwin, by the same. Murray. London.
SECT. XXIX.
ON THE RETROGRADE MOTIONS OF THE ABSORBENT SYSTEM.
I. _Account of the absorbent system._ II. _The valves of the absorbent vessels may suffer their fluids to regurgitate in some diseases._ III.
_Communication from the alimentary ca.n.a.l to the bladder by means of the absorbent vessels._ IV. _The phenomena of diabetes explained._ V. 1.
_The phenomena of dropsies explained._ 2. _Cases of the use of foxglove._ VI. _Of cold sweats._ VII. _Translations of matter, of chyle, of milk, of urine, operation of purging drugs applied externally._ VIII. _Circ.u.mstances by which the fluids, that are effused by the retrograde motions of the absorbent vessels, are distinguished._ IX. _Retrograde motions of vegetable juices._ X. _Objections answered._ XI. _The causes, which induce the retrograde motions of animal vessels, and the medicines by which the natural motions are restored._
_N.B. The following Section is a translation of a part of a Latin thesis written by the late Mr. Charles Darwin, which was printed with his prize-dissertation on a criterion between matter and mucus in 1780.
Sold by Cadell, London._
I. _Account of the Absorbent System._
1. The absorbent system of vessels in animal bodies consists of several branches, differing in respect to their situations, and to the fluids, which they absorb.
The intestinal absorbents open their mouths on the internal surfaces of the intestines; their office is to drink up the chyle and the other fluids from the alimentary ca.n.a.l; and they are termed lacteals, to distinguish them from the other absorbent vessels, which have been termed lymphatics.
Those, whose mouths are dispersed on the external skin, imbibe a great quant.i.ty of water from the atmosphere, and a part of the perspirable matter, which does not evaporate, and are termed cutaneous absorbents.
Those, which arise from the internal surface of the bronchia, and which imbibe moisture from the atmosphere, and a part of the bronchial mucus, are called pulmonary absorbents.
Those, which open their innumerable mouths into the cells of the whole cellular membrane; and whose use is to take up the fluid, which is poured into those cells, after it has done its office there; may be called cellular absorbents.
Those, which arise from the internal surfaces of the membranes, which line the larger cavities of the body, as the thorax, abdomen, s.c.r.o.t.u.m, pericardium, take up the mucus poured into those cavities; and are distinguished by the names of their respective cavities.
Whilst those, which arise from the internal surfaces of the urinary bladder, gall-bladder, salivary ducts, or other receptacles of secreted fluids, may take their names from those fluids; the thinner parts of which it is their office to absorb: as urinary, bilious, or salivary absorbents.
2. Many of these absorbent vessels, both lacteals and lymphatics, like some of the veins, are replete with valves: which seem designed to a.s.sist the progress of their fluids, or at least to prevent their regurgitation; where they are subjected to the intermitted pressure of the muscular, or arterial actions in their neighbourhood.
These valves do not however appear to be necessary to all the absorbents, any more than to all the veins; since they are not found to exist in the absorbent system of fish; according to the discoveries of the ingenious, and much lamented Mr. Hewson. Philos. Trans. v. 59, Enquiries into the Lymph. Syst. p. 94.
3. These absorbent vessels are also furnished with glands, which are called conglobate glands; whose use is not at present sufficiently investigated; but it is probable that they resemble the conglomerate glands both in structure and in use, except that their absorbent mouths are for the conveniency of situation placed at a greater distance from the body of the gland. The conglomerate glands open their mouths immediately into the sanguiferous vessels, which bring the blood, from whence they absorb their respective fluids, quite up to the gland: but these conglobate glands collect their adapted fluids from very distant membranes, or cysts, by means of mouths furnished with long necks for this purpose; and which are called lacteals, or lymphatics.
4. The fluids, thus collected from various parts of the body, pa.s.s by means of the thoracic duct into the left subclavian near the jugular vein; except indeed that those collected from the right side of the head and neck, and from the right arm, are carried into the right subclavian vein: and sometimes even the lymphatics from the right side of the lungs are inserted into the right subclavian vein; whilst those of the left side of the head open but just into the summit of the thoracic duct.
5. In the absorbent system there are many anastomoses of the vessels, which seem of great consequence to the preservation of health. These anastomoses are discovered by dissection to be very frequent between the intestinal and urinary lymphatics, as mentioned by Mr. Hewson, (Phil. Trans. v. 58.)
6. Nor do all the intestinal absorbents seem to terminate in the thoracic duct, as appears from some curious experiments of D. Munro, who gave madder to some animals, having previously put a ligature on the thoracic duct, and found their bones, and the serum of their blood, coloured red.
II. _The Valves of the Absorbent System may suffer their Fluids to regurgitate in some Diseases._
1. The many valves, which occur in the progress of the lymphatic and lacteal vessels, would seem insuperable obstacles to the regurgitation of their contents. But as these valves are placed in vessels, which are indued with life, and are themselves indued with life also; and are very irritable into those natural motions, which absorb, or propel the fluids they contain; it is possible, in some diseases, where these valves or vessels are stimulated into unnatural exertions, or are become paralytic, that during the diastole of the part of the vessel to which the valve is attached, the valve may not so completely close, as to prevent the relapse of the lymph or chyle. This is rendered more probable, by the experiments of injecting mercury, or water, or suet, or by blowing air down these vessels: all which pa.s.s the valves very easily, contrary to the natural course of their fluids, when the vessels are thus a little forcibly dilated, as mentioned by Dr. Haller, Elem. Physiol. t. iii. s. 4.
"The valves of the thoracic duct are few, some a.s.sert they are not more than twelve, and that they do not very accurately perform their office, as they do not close the whole area of the duct, and thence may permit chyle to repa.s.s them downwards. In living animals, however, though not always, yet more frequently than in the dead, they prevent the chyle from returning. The princ.i.p.al of these valves is that, which presides over the insertion of the thoracic duct, into the subclavian vein; many have believed this also to perform the office of a valve, both to admit the chyle into the vein, and to preclude the blood from entering the duct; but in my opinion it is scarcely sufficient for this purpose." Haller, Elem.
Phys. t. vii. p. 226.
2. The mouths of the lymphatics seem to admit water to pa.s.s through them after death, the inverted way, easier than the natural one; since an inverted bladder readily lets out the water with which it is filled; whence it may be inferred, that there is no obstacle at the mouths of these vessels to prevent the regurgitation of their contained fluids.
I was induced to repeat this experiment, and having accurately tied the ureters and neck of a fresh ox"s bladder, I made an opening at the fundus of it; and then, having turned it inside outwards, filled it half full with water, and was surprised to see it empty itself so hastily. I thought the experiment more apposite to my purpose by suspending the bladder with its neck downwards, as the lymphatics are chiefly spread upon this part of it, as shewn by Dr. Watson, Philos. Trans. v. 59. p. 392.
3. In some diseases, as in the diabetes and scrophula, it is probable the valves themselves are diseased, and are thence incapable of preventing the return of the fluids they should support. Thus the valves of the aorta itself have frequently been found schirrous, according to the dissections of Mons. Lieutaud, and have given rise to an interrupted pulse, and laborious palpitations, by suffering a return of part of the blood into the heart. Nor are any parts of the body so liable to schirrosity as the lymphatic glands and vessels, insomuch that their schirrosities have acquired a distinct name, and been termed scrophula.
4. There are valves in other parts of the body, a.n.a.logous to those of the absorbent system, and which are liable, when diseased, to regurgitate their contents: thus the upper and lower orifices of the stomach are closed by valves, which, when too great quant.i.ties of warm water have been drank with a design to promote vomiting, have sometimes resisted the utmost efforts of the abdominal muscles, and diaphragm: yet, at other times, the upper valve, or cardia, easily permits the evacuation of the contents of the stomach; whilst the inferior valve, or pylorus, permits the bile, and other contents of the duodenum, to regurgitate into the stomach.
5. The valve of the colon is well adapted to prevent the retrograde motion of the excrements; yet, as this valve is possessed of a living power, in the iliac pa.s.sion, either from spasm, or other unnatural exertions, it keeps itself open, and either suffers or promotes the retrograde movements of the contents of the intestines below; as in ruminating animals the mouth of the first stomach seems to be so constructed, as to facilitate or a.s.sist the regurgitation of the food; the rings of the oesophagus afterwards contracting themselves in inverted order. De Haeu, by means of a syringe, forced so much water into the r.e.c.t.u.m intestinum of a dog, that he vomited it in a full stream from his mouth; and in the iliac pa.s.sion above mentioned, excrements and clyster are often evacuated by the mouth. See Section XXV. 15.